The legacy of mercury poisoning in Grassy Narrows First Nation - - PowerPoint PPT Presentation

Donna Mergler CINBIOSE, Université du Québec à Montréal Judy DaSilva Asubpeeschoseewagong Netum Anishinabek (Grassy Narrows First Nation) Myriam Fillion Université TÉLUQ Aline Philibert CINBIOSE, Université du Québec à Montréal

First Nations Food, Nutrition and Environment Forum Ottawa, November 5 2019

The legacy of mercury poisoning in Grassy Narrows First Nation

You cannot talk about the people without talking about the land from which they come from.

The Grassy Narrows community fights for recognition and their rights

Health assessments

• 1979: Neurological examinations “revealed effects that may be associated

with methylmercury poisoning but a definitive diagnosis remained elusive”. (Wheatley, 1979)

• 1986: Dr. Brian Postl examined Grassy Narrows’ morbidity and mortality

records from the local hospital. The report indicated that the community “experienced illness and death at rates which far exceed district, provincial and national standards”.

• 1975 – 2011: Dr. Masazumi Harada and his team examined persons at four
• ccasions and reported many cases of clinical Minamata Disease and

Minamata Disease with complications.

• In 2015 - 2018: Grassy Narrows carried out a community-based health

assessment.

Grassy Narrows’ Community Health Assessment

• Community-driven survey: community participation in all aspects
• Questionnaire was adapted from the First Nations Regional Health Survey,

including new questions (e.g. fish consumption, neurological conditions)

• Computer-based survey between December 2016 and March 2017
• 9 community surveyors going house-to house
• Participation rate: 78% - 424 adult and 353 children

2 main questions 1. How does the health and well-being of Grassy Narrows First Nation fare in comparison with other First Nations? 2. Do past and present fish consumption, which are indicators of mercury exposure, contribute to poor health and well-being?

Financial support : Health Canada and Ontario Ministry for Health and Long-term Care

How does Grassy Narrows First Nation fare in comparison with other First Nations?

Ontario Canada

Comparison with other First Nation communities

21%$ 40%$ 44%$ 60%$ Grassy$Narrows$ First$Na3ons$in$ Ontario$ First$Na3ons$in$ Canada$ Canada$

Thriving (health perception: very good or excellent)

• This is mirrored in the percentage of those who have at least one chronic

health condition.

• Diabetic co-morbidity is more frequent in Grassy Narrows, despite the fact

that proportionally more diabetics in Grassy Narrows attend clinics or education

Comparison with other First Nation communities

Severe food insecurity

24%$ 15%$ 13%$ Grassy$Narrows$ First$Na3ons$in$ Ontario$ First$Na3ons$in$ Canada$ 41%$ 21%$ 22%$ Grassy$Narrows$ First$Na1ons$in$ Ontario$ First$Na1ons$in$ Canada$

Not working because of a disability

• r health or mental problem

among the unemployed

54%$ 37%$ 40%$ Grassy$Narrows$ First$Na3ons$in$ Ontario$ First$Na3ons$in$ Canada$

Struggle to pay for food at least a few times a year

Suicidal ideation

33% 7% 13% Grassy Narrows First Na1ons in Ontario First Na1ons in Canada

Attempted suicide

28% 13% 13% Grassy Narrows First Na2ons in Ontario First Na2ons in Canada 37% 25% 22% Grassy Narrows First Na2ons in Ontario First Na2ons in Canada

Family member or close friend committed suicide

Comparison with other First Nation communities

Children less than 12 years of age

Grassy Narrows First Nations in Ontario First Nations in Canada Low birth weight (<2.5 kg) 4% 5% Breastfed 63% 65% 60% Thriving (health excellent or very good) 73% 85% 88% Mental health (very good/excellent) 52% 65% Chronic ear infections or ear problems 17% 7% 6% Speech / language difficulties 11% 6% 5% Learning disability 9% 4% 3% Conditions impact school performance: 6 – 11y 19% 7% Emotional or behaviour problems: 3 – 11 y 27% 15% 14% Emotional or behaviour problems: 9 – 11 y 37% 18%

Youth 12-17 years of age

Grassy Narrows First Nations in Ontario First Nationss in Canada Allergies 13% 18% 16% Asthma 13% 15% 13% Anaemia 11% 2% Chronic ear infections 23% 7% 3% Dermatitis 14% 4% 4% Conditions that impact school performance 16% 7% Attends school 91% 88% Difficulty in school 52% 39% Short attention span 32% 21% Too many distractions 59% 39% Difficulty understanding 37% 28%

Subtle changes which impact individuals and the community Obvious symptoms of nervous system dysfunction Clinical mercury poisoning: a progressive neurologic disorder

Mercury exposure

A continuum of severity of effects Do past and present fish consumption, which are indicators of mercury exposure, contribute to their poor health and well-being?

Fish consumption: indicators of mercury exposure

Adults:

• How much fish did you eat when you were 10 years old?

At least several fish meals a week vs. fewer

• How much walleye did you eat over the past year?

Often: (median 3 fish meals/month) A few times or never (median 1 fish/month) Children:

• How much fish did you (mother) eat when you were pregnant with

this child ? Never/hardly ever; once a month; once a week or more

• Significant dose-related associations were observed between symptom

clusters and reported childhood and/or current fish consumption for: – Paresthesia in extremities – Motor difficulties – Difficulty swallowing, stumbling, falls – Loss of memory, difficulty concentrating – Anxiety, depression

Taking into account as required: age, sex, at least one chronic health condition, alcohol use, smoking, nutrition, mother in residential school

Adults

• For persons 18-49 years of age,

childhood fish consumption was associated with: – Perceiving their health as poor – Having done fairly/poorly in school – Income less than $20,000/y – Struggle to pay for food

Results of mutiple regression models, taking into account, as required: age, sex, at least one chronic health condition, alcohol use, smoking, nutrition, obesity, parent in residential school

Adults

• For persons 50+ years of age:

– 50% had been told by a health professional that they had mercury poisoning

Child/youth (4 -17 years) health conditions1 with respect to maternal fish consumption during pregnancy

1 fish meal/ month 1 fish meal/ week or more

Health less than very good or excellent (not thriving) X Chronic diagnosed conditions Visual problems

• ------X-------
• ------X-------

Chronic ear infections Learning/speech disability X At least one nervous system disorder X Conditions that may impact school performance2 X

1. Models include: mother’s alcohol consumption during pregnancy, gestational diabetes and/or hypertension, difficulties at childbirth and child’s age and sex 2. Measure used by the First Nations Regional Health Survey 2008/2010 for children: includes having one of the following conditions: cognitive or mental disability, a learning disability, ADD/ADHD or speech and language difficulties

Question: “Did the child/youth have more emotional or behavioural problems compared to other children of the same age and sex over the past 6 months?”

Maternal fish consumption during pregnancy

Conclusions of the Grassy Narrows Community Health Assessment (2018)

• Grassy Narrows First Nation has poorer physical and mental

health, and more socio-economic difficulties compared to

• ther First Nation communities in Ontario and in Canada.
• Fish consumption, particularly during childhood,

significantly contributes to poor health and well-being of individuals and the community.

• The specific deficits and the long-term effects of childhood

exposure are consistent with the scientific literature on the detrimental effects of mercury on health.

Recommendations

• Remediation: elimination of mercury from the lakes, rivers and fish.
• Increased funding and appropriate programs for physical and

mental health.

• A long-term care facility on reserve that addresses the issues of

mercury poisoning, with appropriate out-patient services for those with symptoms (e.g. physiotherapy, vision care, cognitive stimulation…).

• Programs for food security, with access to healthy food, including

uncontaminated walleye.

• Long term, stable institutions to facilitate the sharing of knowledge,

culture and traditional healing by Grassy Narrows should be supported and augmented.

Current studies with Grassy Narrows

• Examine premature mortality (<60 years) with respect to longitudinal

exposure to mercury

• Verify the findings of the CHA using longitudinal biomarker data
• Analyze mercury distribution in the brain and other organs from

autopsies performed on people from Grassy Narrows